Breast reconstruction can be pursued for many different medical and personal reasons, ranging from cancer treatments to the desire for restoration after trauma. This surgery can help restore your physical form while also supporting your overall well-being. At Plastic Surgery Specialists of South Florida, we offer breast reconstruction to patients in Hollywood, FL, and the surrounding areas.
We offer a wide range of techniques and options to meet the diverse situations of our patients. Whether you need immediate reconstruction following a mastectomy or a delayed procedure to allow time for personal readiness or additional treatments, we can achieve results that feel natural and comfortable.
What Is Breast Reconstruction?
Breast reconstruction is the surgical process that restores the breast’s shape and size following a mastectomy, injury, or condition that altered its appearance. Through this procedure, we can reinstate symmetry between the breasts and create a natural shape. We offer both implants and autologous methods, offering the widest range of methods in the area.
Common Reasons for Breast Reconstruction
Post-Mastectomy Reconstruction
Breast reconstruction after mastectomy rebuilds the breast to match its original shape and size or to enhance symmetry following the surgical removal of breast tissue due to cancer or disease. We are experienced in all of the intricacies that come with this process, from working with your oncology surgeon to addressing unique challenges that may come with your case.
Congenital Defects and Asymmetry Correction
Individuals with congenital breast defects or noticeable asymmetry may turn to breast reconstruction surgeons for corrective procedures. These surgeries can improve aesthetic balance and personal comfort through a variety of methods.
Reconstruction After Trauma
For those recovering from traumatic breast injuries, breast reconstruction surgery can help you regain a natural appearance while supporting emotional healing. We cater to each patient’s aesthetic preferences while working to facilitate recovery after accidents or non-cancer related surgical interventions.
Different Types of Reconstruction Methods
Implant-Based Reconstruction
Implant-based reconstruction is a common method for breast reconstruction after mastectomy, where breast implants are used to recreate the breast mound. This approach can be performed in a single stage, where the implant is placed immediately after the mastectomy, or in a staged approach, starting with the placement of a tissue expander to gradually stretch the skin and muscle to accommodate the implant. This surgery can be performed with either silicone or saline implants, depending on the situation.
Autologous (Flap) Reconstruction
Autologous, or flap reconstruction, uses the patient’s own tissue from another part of the body to reconstruct the breast. This method can provide a more natural look and feel than implant-based reconstruction, as it involves transferring skin, fat, and sometimes muscle to create the breast shape. Flap reconstructions are complex and require a skilled surgical team but are often chosen for their durable and natural-looking results. We are experienced in many different methods, including:
- DIEP (Deep Inferior Epigastric Perforator): This procedure uses fat, skin, and blood vessels from the lower abdomen, similar to a tummy tuck, but preserves the abdominal muscles, leading to a quicker recovery and less impact on abdominal strength.
- SIEA (Superficial Inferior Epigastric Artery): Similar to DIEP, the SIEA flap involves using tissue from the abdominal area but uses different blood vessels, avoiding the need to move the muscle at all, which can result in even less impact on abdominal strength.
- TUG (Transverse Upper Gracilis): The TUG technique takes muscle and fat from the upper inner thigh to reconstruct the breast. This option is sometimes preferred for its ability to create a breast from tissue that closely matches the feel of breast tissue.
- SGAP (Superior Gluteal Artery Perforator): This method uses tissue from the upper buttock to reconstruct the breast, preserving muscle and minimizing donor site morbidity. This option is often considered for patients who do not have sufficient abdominal tissue.
- IGAP (Inferior Gluteal Artery Perforator): Similar to SGAP, the IGAP flap also uses tissue from the buttock area but focuses on the lower part of the buttocks. It’s another alternative for patients lacking adequate abdominal tissue for reconstruction.
Combination Surgeries
In reconstructive breast surgery, combination surgeries involve using both implant and autologous tissue techniques to achieve the desired breast shape and volume. This approach allows for the customization of reconstruction to address individual patient needs, optimizing the aesthetic and functional outcomes by leveraging the benefits of both methods.
Immediate vs. Delayed Reconstruction: Which Is Right for You?
The decision between immediate and delayed breast reconstruction often depends on factors such as your cancer treatment plan, overall health, and personal preferences. Immediate reconstruction is performed during the same surgery as a mastectomy, which can reduce the need for multiple operations and preserve the natural breast skin for better cosmetic outcomes. However, it is sometimes not an option if additional treatments like radiation are required, as these can impact healing and the results of reconstruction.
Delayed reconstruction allows your body to heal fully after a mastectomy and any necessary cancer treatments before undergoing reconstruction. This approach can provide more flexibility in planning the reconstruction procedure and may be recommended if you need time to decide on the best reconstructive option. Your surgeon will work closely with you and your oncologist to determine the timing that aligns best with your medical and personal circumstances.
Preparing for Breast Reconstruction
Preparation for breast reconstruction may include medical evaluations, understanding the different reconstruction methods available, and setting realistic expectations for the outcome. Patients are also advised on how to prepare physically and mentally for surgery, including dietary adjustments, cessation of smoking, and arranging for post-operative support.
- Reviewing Your Medical History and Goals: We’ll carefully review your medical history to understand any factors that might influence your surgery and recovery. This includes past procedures, current medications, and any ongoing health conditions.
- Discussing Options for Reconstruction: Each patient’s needs are unique, so we take the time to discuss all available reconstruction techniques, from implants to flap-based methods. This conversation includes details about the benefits and limitations of each option, allowing you to make an informed decision based on your personal preferences and medical suitability.
- Performing a Physical Examination: A thorough physical examination helps us evaluate your anatomy and overall health. This helps us determine which reconstruction methods are feasible and helps us plan surgical details like incisions, tissue availability, and implant placement.
- Creating Your Surgical and Recovery Plan: Next, we’ll set a surgery date, arrange post-operative care, and provide you with clear instructions to help ensure a smooth recovery.
What to Expect During Breast Reconstruction
During breast reconstruction surgeries, patients are usually placed under general anesthesia. In flap-based reconstruction, the surgery begins by carefully harvesting tissue, which includes skin, fat, and sometimes muscle, from the chosen area. For free flap techniques, the tissue is fully detached and transferred to the breast area. Here, your surgeon meticulously reconnects blood vessels using microsurgical techniques to restore circulation and ensure the transferred tissue thrives. Pedicled flap techniques leave the tissue partially attached to its original blood supply as it is tunneled to the breast area. Once the tissue is secured and sculpted into the desired shape, the incisions at both the donor and breast sites are closed with precision to minimize scarring.
Implant reconstruction often involves a staged approach. For many patients, the first step is placing a tissue expander beneath the chest muscle to gradually stretch the skin and make room for the implant. This is done during the initial surgery or at the time of the mastectomy. Over several weeks, the expander is filled incrementally with saline to achieve the desired breast size.
Once the skin has sufficiently stretched, a second surgery replaces the expander with a permanent implant, typically made of silicone or saline. In direct-to-implant reconstruction, this two-step process may be skipped, with the implant placed immediately during the initial surgery. Your surgeon will carefully position the implant to create a natural breast contour and promote symmetry.
Breast Reconstruction Recovery
Recovery from reconstructive breast surgery involves a period of healing and adjustment that can last several weeks. Patients may experience discomfort, swelling, and bruising, for which pain management and care instructions will be provided. Patients recovering from breast reconstruction surgery should also be prepared for gradual improvements in mobility and strength. While the initial weeks focus on rest, light activities like short walks are typically encouraged to promote circulation and reduce the risk of complications. Depending on the reconstruction method, drains may be placed to prevent fluid buildup, and these are usually removed within one to two weeks. It’s important to follow all post-operative guidelines, including restrictions on physical activities and attending follow-up appointments for optimal healing.
Frequently Asked Questions About Breast Reconstruction
Am I a Good Candidate for Breast Reconstruction?
Candidates for breast reconstruction surgery should have a stable recovery status and be in good physical health to support proper healing after surgery. For flap-based reconstruction, the amount of available tissue in areas like the abdomen, back, or thighs is a key consideration. Your body type, skin elasticity, and overall surgical readiness are evaluated to determine the most suitable reconstruction method.
How Long Does Breast Reconstruction Take?
The time required for breast reconstruction varies depending on the method. Implant-based reconstruction typically involves one to two hours for the initial surgery and an additional procedure if a tissue expander is used. Flap-based reconstruction is more intricate, often taking four to eight hours or more to complete, depending on the donor site and surgical complexity. Any additional procedures for symmetry or refinement may further extend the timeline.
Is Breast Reconstruction Covered By Insurance?
Most health insurance plans are required by federal law to cover breast reconstruction surgery after mastectomy. This may include both implant-based and flap reconstruction methods, as well as procedures for symmetry. However, to avoid unexpected expenses, it’s important to review your insurance plan and confirm coverage details with your provider in advance since coverage can vary.
How Long Does It Take to See Final Results?
The timeline for seeing the final appearance of a reconstructed breast after mastectomy depends on the chosen reconstruction method and individual healing. Implant-based reconstruction can show results within a few weeks, although swelling may take longer to resolve. Flap-based reconstruction typically requires several months for the tissue to heal and adjust. Complete results, including the softening of scars and complete reduction of swelling, are generally visible within 6–12 months.
When Can Breast Reconstruction Be Performed?
Breast reconstruction can be timed to coincide with the mastectomy procedure, known as immediate reconstruction, in collaboration with the surgical oncologist. This option might be suitable for some patients, offering the benefit of fewer surgeries and a quicker start to the reconstruction process. Reconstruction can also be delayed until after the patient has fully recovered from the mastectomy and any additional treatments, such as chemotherapy or radiation, allowing for a separate focus on each phase of treatment and recovery.
Do I Need to Wait Until After Chemo or Radiation Therapy for Breast Reconstruction?
While not always necessary, it may be recommended by breast reconstruction surgeons to wait until after completing chemotherapy or radiation therapy before proceeding with breast reconstruction. Every situation is different, and the timing is always carefully personalized for safety and best results.
Will My Reconstructed Breasts Look and Feel Natural?
Through breast reconstruction surgery, achieving a natural look and feel is a primary goal. Advances in surgical techniques and materials mean reconstructed breasts can closely mimic the appearance and sensation of natural breast tissue but may not be exactly as you remember your original breast tissue. Make sure to discuss your expectations and concerns with your surgeon to understand what might be achieved in your situation.
Can I Have Breast Reconstruction Years After a Mastectomy?
Yes, breast reconstruction surgeries can be successfully performed years after a mastectomy. Many patients opt for reconstruction long after their initial surgery due to personal, medical, or financial reasons. Regardless of the time elapsed, reconstructive options are available to suit individual needs and goals, with a comprehensive evaluation by a reconstructive surgeon to determine the best approach.
Why Choose Us for Breast Reconstruction?
At Plastic Surgery Specialists of South Florida, we combine decades of experience with advanced training in breast reconstruction techniques. Dr. Yoav Barnavon brings over 22 years of expertise, including specialized breast reconstruction training at MD Anderson Cancer Center, one of the leading institutions for complex breast reconstructions. Dr. Jason Levine is celebrated for his compassionate care and excellence in surgery, with accolades such as the Outstanding Chief Resident Award reflecting his dedication to patient outcomes. Dr. Hwee offers an innovative perspective, shaped by a diverse educational background and numerous awards recognizing his achievements in plastic surgery. Together, we prioritize a personalized approach to every procedure to meet your unique needs and preferences.
